不同手术方式对女性单侧cT1N0-1a期甲状腺癌治疗效果及切口美容满意度的影响

The influence of different surgical methods on the treatment effect of female unilateral cT1N0-1a thyroid cancer and the satisfaction of incision beauty

目的对比两种不同手术方式治疗女性单侧cT1N0-1a期甲状腺癌的效果及切口美容满意度。方法2020年10月~2022年9月收治的女性单侧cT1N0-1a期甲状腺癌病人120例,按手术方式不同分为开放组(65例)与经口组(55例),开放组行传统开放甲状腺手术,经口组行经口腔前庭入路腔镜甲状腺手术,比较两组病人术中情况、术后并发症及术后切口美容满意度。结果经口组手术时间为(124.40±11.59)分钟,清扫中央区淋巴结所用时间为(26.44±5.33)分钟,开放组分别为(65.91±11.44)分钟和(17.38±4.32)分钟,两组比较差异有统计学意义(P<0.05)。经口组术后Vancouver瘢痕评分为(3.29±0.96)分,病人瘢痕评分为(8.62±1.57)分,观察者瘢痕评分(6.67±1.17)分,瘢痕自我意识评分(1.65±0.70)分,开放组分别为(5.29±1.20)分、(15.02±2.85)分、(19.57±2.94)分、(3.12±0.98)分,两组比较差异有统计学意义(P<0.05)。两组术中出血量、术后引流量、住院时间、中央区淋巴结清扫数量比较差异均无统计学意义(P>0.05)。经口组与开放组术后并发症(声音嘶哑、饮水呛咳、术后出血、皮下积液)的总发生率比较差异无统计学意义(7.2%比7.6%,P>0.05)。结论两种手术方式各有优势,术后并发症发生率低,均安全、可靠,经口组病人对术后切口美容满意度更高,可根据病人具体情况选择合适的术式。

Objective To compare the effects of two different surgical methods in the treatment of female unilateral cT1N0-1a thyroid cancer and the satisfaction of incision cosmetics.Methods A retrospective analysis of the data of female patients with unilateral cT1N0-1a stage thyroid cancer in our hospital from October 2020 to September 2022 was conducted.They were divided into open group(65 cases)and oral group(55 cases)according to different surgical methods.Patients in open group were underwent traditional open thyroid surgery,and patients in oral group were underwent transoral vestibular approach laparoscopic thyroid surgery.Intraoperative conditions,postoperative complications and satisfaction degree of postoperative incision beauty between the two groups were comparded.Results The operation time was(124.40±11.59)minutes and the dissection time of the central lymph node was(26.44±5.33)minutes in the transoral group,which were longer than those in the open group[(65.91±11.44)minutes and(17.38±4.32)minutes,(P<0.05)].Vancouver scar evaluation[(3.29±0.96)points],patient scar evaluation[(8.62±1.57)points],observer scar evaluation[(6.67±1.17)points]and scar self-awareness score[(1.65±0.70)points]in the oral group were significantly lower than those in the open group[(5.29±1.20)points,(15.02±2.85)points,(19.57±2.94)points and(3.12±0.98)points,(P<0.05)].There were no significant difference in the amount of blood loss,the amount of drainage,the number of days in hospital and the number of central lymph nodes dissection between the two groups(P>0.05).There was no significant difference in total incidence of postoperative complications(hoarseness,cough after drinking water,postoperative bleeding,subcutaneous effusion)between oral group and open group(7.2%vs 7.6%,P>0.05).Conclusion The two surgical methods have their own advantages,the incidence of postoperative complications is low,safe and reliable,and the patients in the oral group are more satisfied with the cosmetology of the postoperative incision.In actual clinical work,the appropriate operation can be chosen according to the specific conditions of the patients.